Now, a newly awarded federal grant will allow one service provider to triple the number of unhoused young adults in Multnomah County who attend its individual and group therapy sessions.

Outside In will offer the counseling service to approximately 160 youths ages 18 to 25, thanks to a $2.5 million grant from the U.S. Department of Health and Human Services. Six unionized staffers will oversee the program.

"We're trying to help folks manage today in order to focus on the future or focus on goals," said clinical services manager Amanda Antenucci. "We had to turn away a lot of people before, and there's just a lot of need."

Previously, Outside In had space for only about 60 youths — though the nonprofit assists 11,000 people annually, with the lion's share receiving medical care. The new in-house program, RISE Support, complements the pre-existing RISE Intensive program.

Both offerings focus on mindfulness, but the new program will emphasize teaching stress tolerance, emotional regulation and psychological flexibility, using frameworks known as Dialectical Behavior Therapy and Acceptance Commitment Therapy.

Makayla Caldwell is singing the praises of the therapy options, and she should know. Less than a year ago, the 21-year-old was homeless and camping out in an area near downtown Hillsboro.

"I was just spiraling down," said Caldwell, who grew up in Missouri. "Every day you're experiencing some sort of trauma."

Caldwell said she was working 40 hours a week in customer service. But when the landlord of her house raised the rent, she had nowhere to go.

Eventually, she started getting an hour of one-one-one therapy a week at Outside In, plus another 90 minutes of group therapy weekly. Caldwell is now studying multimedia and video production at Portland Community College, and works as a peer mentor at Outside the Frame, an affiliated program with a separate funding source.

"When you're experiencing complex trauma, you have a lot of triggers and buttons that can be pressed," Caldwell said. "My job is feeling the room and noticing when someone is getting into that distressed state."

Local service providers believe there are over 1,000 homeless young adults in Multnomah County who could benefit from these counseling services. At least 35 percent of them identify as lesbian, gay, bisexual or transgender.

"Imagine how hard it is to make group therapy at three o'clock on Thursday if you're trying to make sure people aren't trying to steal stuff out of your tent," Antenucci said.

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